Behavioral Activation: a very effective therapy in depression

Both depression and any of the conditions or disorders related to it, have been a great field of research from the point of view of psychological treatment. Throughout the history of psychology, researchers have struggled to develop an effective therapy that alleviates its symptoms in the shortest possible time.

One of these recently acting treatments is Behavioral Activation. A therapy that starts from the idea that modifying the patient's behaviors will have a positive impact on her mood.

• Related article: "Types of psychological therapies"

What is Behavioral Activation?

Behavioral Activation (CA) is a relatively new therapy, it does not have much more than 30 years of story behind it, which treats depression functionally and from the point of view of the context of the person.

According to the creators of this type of intervention, Behavioral Activation relies on the person's context to explain their symptoms. Thus, therapy defends that acting on this context is much more effective than doing it on the symptoms or internal factors, such as neurobiological disorders or symptoms psychological.

In addition, Behavioral Activation establishes that the behaviors carried out by people with depression are more that simple symptoms of the clinical picture, and that these have a very important significance within the disorder.

The psychological mechanism on which Behavioral Activation is based has to do with the initiation of habits capable of provide immediate and medium-term incentives, capable of making the person become more psychologically active and mentally. That is, through new ways of interacting with the environment and with others, a more optimistic and constructive mentality is being favored, oriented to concrete goals and in which one can focus, letting go of disturbing thoughts.

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How did it appear?

Behavioral Activation originated from behavioral techniques that are carried out within the Aaron Beck's Cognitive Therapy.

The initial idea was to make a comparison between the behavioral part of the traditional intervention, the behavioral intervention together with the cognitive and integral therapy. After making this comparison, the results showed that only by carrying out a behavioral modification in the patient, this presented the same level of improvement as with the full intervention.

Therefore, it was concluded that cognitive intervention techniques or modifications were not as necessary in the treatment of depression, assuming only a drag on the treatment. Following these conclusions, it was proposed to consider the purely behavioral intervention as a therapy independent of traditional cognitive therapy, becoming what is now known as Activation Behavioral.

It is necessary to specify that although Behavioral Activation does not work on the person's cognition, it is not ignored. Rather, they are expected to change as a result of behavior modifications.

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Principles of Behavioral Activation

There are two aspects to take into account when starting an intervention through Behavioral Activation:

• The context or situation that provokes the behavior.
• The functionality or the effects has this behavior on the person.

In this way, Behavioral Activation assesses and analyzes both the events that appear in the patient's life, as well as the behavioral responses that this this gives to these situations.

Regarding the responses of the person, one of the basic principles of Behavioral Activation is that the person with depression carries out a series of avoidant behaviors consequence of the lack of positive reinforcement and the predominance of little stimulating situations. This avoidance tendency can manifest itself through the interruption of daily tasks and activities, through ruminative thoughts or through the interactions that the person has or does not have with the rest of persons.

How is it carried out as a psychological intervention?

Taking into account the principle of behavioral avoidance, Behavioral Activation therapy aims to restore the person's behavioral dynamics prior to depression.

The first step to achieve this is to activate the person, hence the name of the therapy, despite the fact that they are depressed. Through this, Behavioral Activation aims to systematically increase the number of positive behaviors carried out by the person with the intention that he / she finds a greater number of reinforcers that promote a change in the person at the level of behavior, cognition and mood.

However, Behavioral Activation does not try to increase the number of behaviors of the person regardless of the nature of these, but rather a functional behavior analysis should be performed to detect those significant and functional behaviors which should be promoted.

Therefore, Behavioral Activation is a therapy that is developed and adapted to the singularities of the patient.

Finally, the dynamics of therapy is not to modify cognition and mood so that the person changes her behavior, but to act despite the mood. This specific point is closely associated with the Acceptance and commitment therapy, in which the person must first accept their current condition to act and be able to change it.

Advantages of this type of psychotherapy

The defenders of Behavioral Activation therapy rely on a series of advantages or benefits that it provides compared to other therapies such as pharmacological or cognitive.

These advantages are as follows.

1. Demedicalization

Behavioral Activation is presented as an effective and fast alternative to drug treatment for depression, being as effective as this one and without causing unwanted side effects.

Therefore, this discourse in favor of demedicalization has managed to win many followers.

2. Alternative to cognitive therapy

As an alternative to cognitive therapy, Behavioral Activation has proven to be much more effective and with much faster results. Since the modification of thoughts and beliefs requires a greater investment of time.

3. Quick results

Thanks to the adjustment of the therapy to the needs of the patient and the structuring of this, the Behavioral Activation It is a therapy that requires a few sessions, about 15 approximately, which supposes a rapidity in the results and an economic advantage in comparison with other forms of psychological intervention.

Bibliographic references:

• Jacobson, N.S.; Dobson, K.S.; Truax, P.A.; Addis, M.E.; Koerner, K.; Gollan, J.K.; Gortner, E. & Prince, S.E. (nineteen ninety six). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology. 64 (2): pp. 295 - 304.
• Martell, C.R.; Addis, M.E. & Jacobson, N.S. (2001). Depression in context: Strategies for guided action. New York: W. W. Norton.
• Twyman, J.S. (2007). A new era of science and practice inbehavior analysis. Association for Behavior Analysis International: Newsletter, 30 (3): pp. 1 - 4.